This Podcast is in Partnership with Neurolens
Optometrists may be surprised to realize that there is a very common condition that they might have never heard of that’s causing our patients to suffer from chronic headaches, eye pain, and visual discomfort. And it’s completely treatable by optometrists with a novel new technology to help you diagnose and prescribe glasses that relieve the issue. Sound like a game changer for our profession? We sit down with Chief Technical Officer, Mr. Aric Plumley and Chief Commercial Officer, Mr. Pierre Bertrand of Neurolens in this podcast.
Neurolens technology was inspired by the work of Dr. Krall in Mitchell, South Dakota who was treating chronic headaches with glasses. To investigate his results, researchers visited a team of neurologists who were treating patients who suffered from chronic headaches that were not responding to conventional medical treatment, which included Topamax and Botox injections. These patients were labelled as refractory because no traditional medicine was working for them. They convinced the neurologists to let Dr. Krall try prescribing his headache glasses, and found that 81.6% of these refractory headache patients achieved symptom relief with the glasses. It was a complete game changer for the neurology clinic, and they immediately added an optometry specialty to their office. Around that time, the Vision Council ran a study about the prevalence of computer vision syndrome – headaches, neck pain, and visual eye strain. They found that 65% of US adults are experiencing these symptoms. At that point the founders of Neurolens decided the best place for their technology was with independent optometrists who were seeing these patients on the frontlines.
“I see Neurolens allowing optometry to expand their scope of practice,” Bertrand explains. “We can own headaches. We can own eye strain. These are things that cannot be treated outside of optometry. Our vision for optometry is that we can play a part in redefining good vision beyond 20/20.” He shares how before progressive lenses came to the market in the 1950s, vision was limited to 2 set distances by bifocal glasses. Prescribing generic, standard glasses for digital eye strain complaints is similarly limiting to the relief of headache and eye strain symptoms caused by our high demand digital lifestyles. Neurolens is designed to relieve the underlying issue that is causing the strain – ocular misalignment and trigeminal dysphoria.
Trigeminal dysphoria is a condition that many doctors may not have learned about in optometry school, but it is a common cause of asthenopia resulting from misalignment of the eyes. The extraocular muscles are connected via proprioceptive fibers to the trigeminal nerve. When the extraocular muscles are strained, they send a signal to the trigeminal nerve, resulting in a feeling of referred pain. That’s why when eye muscles are tired, feelings of headache, neck strain, and eye pain similar to a dry eye sensation are the result. Only 2% of glasses that are sold in the United States have any prism component to address ocular misalignment. “The problem lies in the difficulty in measuring eye misalignment,” Plumley explains. There is no uniform measurement for the amount of fixation disparity or the prescribing criterion to address it. “The Neurolens diagnostic device is an objective measuring device for ocular misalignment,” states Plumley. “It’s three times more reliable than any other alignment measurement.” The researchers at Neurolens then wrote a prescribing algorithm based on the input of several highly successful doctors who have experience prescribing prism for this category of patient. Using artificial technology and machine learning, the technology has now been refined with the input from hundreds of doctors and a hundred thousand patients.
“We know that 56% of the 60,000 patients that we’ve measured are symptomatic, and 90% of those patients have eyes that don’t turn in enough at near,” says Plumley. The issue with prescribing typical prism for these patients is that their misalignment is larger at near than at distance, so traditional prism that is the same throughout the entire lens won’t relieve symptoms effectively. To solve this issue, Neurolens uses a contoured prism design which allows for the distance portion of the glasses to have no or lower amounts of prism and then gradually increases the amount of prism to achieve the needed amount when looking through the near point of the lens. “Just like a progressive lens gives a different accommodative relief at near versus far, Neurolenses give a different vergence relief at near versus far,” Plumley states. Data shows that the technology works; 93% of symptomatic patients who were prescribed Neurolens experienced symptom relief.
A lot of optometrists have experienced the challenge of relieving the symptoms of chronic dry eye patients who have improved ocular surface health after treatment, but are still suffering from the tell-tale symptoms of dry eye –ocular pain, discomfort, and irritation. In a recent webinar Dr. Paul Karpecki dubbed this condition of “phantom dry eye” or neuropathic dry eye. “We call it the pain, no stain group,” Plumley says. These patients could be continuing to have symptoms not because of dry eye, which you’ve treated thoroughly, but due to ocular misalignment that is causing referred trigeminal nerve pain. Case studies performed by Dr. Vance Thompson treating post-LASIK patients suffering from chronic dry eye pain with Neurolens glasses showed great improvement in symptoms.
Most patients that benefit from this technology have very low amounts of ocular misalignment in ranges that were traditionally defined as normal (less than 6 prism units of exophoria at near). But even low amounts of exophoria can cause symptoms. Doctors may be concerned about adaptation or risk of returns with prescribing prism for patients that have never worn prism before, but the data shows extremely high patient satisfaction with Neurolens technology. Only 4% of all Neurolens glasses sold to date have been returned by patients stating that they did not relieve their symptoms. “What we’re delivering is not a pair of spectacles, but relief of their symptoms,” states Bertrand. “So if patients aren’t happy with their symptom relief, we provide a lifetime satisfaction guarantee and a 100% refund return policy, so that they are still happy with their experience.”
Patient satisfaction is a hallmark of what makes Neurolens stand apart from other optometric technology on the market. 93% of patients experience relief of their symptoms with Neurolens glasses. Compare that to Sight Science’s recently published study comparing TearCare versus Lipiflow which showed that Tear Care achieved 72% patient symptom relief and Lipiflow achieved 59% patient symptom relief. If a doctor is considering investing in a new technology, the prevalence of digital eye strain and the high patient satisfaction with the prescribed treatment of Neurolens glasses stands apart.
Head to Neurolenses.com to learn more, and take advantage of a new offer to help optometrists add this new technology to their practices during the difficult financial time of COVID-19 which delays payments until January 2021.